Palliative care is specialized medical care for people with serious illnesses. It focuses on providing relief from the symptoms and stress of the illness, with the goal of improving quality of life for both the patient and their family. It’s provided by a team of doctors, nurses, and other specialists who work together to address physical, emotional, and spiritual needs. Palliative care can be provided alongside curative treatment and is not limited by prognosis.

PCU (Palliative Care Unit): is a unit within Prince Faisal Bin Bander Oncology center in which the Palliative Care Physician is the main responsible physician, that specialized in providing service for palliative patients 

Transfer to palliative care unit:

The patient shall be accepted only if the following conditions apply: 

1. He/she must be in a “Do Not Resuscitate” (DNR) condition and an DNR Form must be completely filled.
2. He/she must be known to palliative care, haematology, medical oncology, pediatric hematology/oncology and/or radiation oncology.
3. He/she must have a clear plan of care from the referring department.
4.  A detailed and updated (less than one week old) medical report or transfer note must be available in the chart.
5. He/she and his/her family must understand the DNR, diagnosis, prognosis, treatment options and accept transfer to Palliative Care and a family meeting must have been conducted.
6. His/her PPS/Kamofsky score must be less than 50% or ECOG more than
7. He/she must not be currently receiving chemotherapy or having complications that are directly related to chemotherapy such as febrile neutropenia.
8. No curative treatment must be possible and no further chemotherapy/ targeted therapy/radical radiation treatment must be planned.
9. His/her life expectancy must be less than 6 months.

Palliative care shall accept transfer of care of a new patient; however the primary team must follow the patient jointly with palliative care for at least two weeks. 

For patients who present in the Emergency room the following shall be applied: 

1. Palliative care shall not accept transfer of care from ER. However, the palliative care team shall accept patient s as consultations from the Oncology/Primary team. 

2. If the patient was transferred previously to Palliative Care, he/she shall be seen by Palliative Care Team. 

3. If the patient is not known to palliative care and other departments of King Fahad Specialist Hospital then he/she shall be seen by the Oncology/Primary Team. Transfer of care shall be considered on the next working day in accordance with other conditions mentioned in this policy.  

4.Consultant Oncologist, Haematologist, Radiation Oncologist or Paediatric Haematologist and Oncologist must indicate the reason for transferring the patient’s care to palliative support. (e.g failure to respond to chemotherapy, patient can’t tolerate chemotherapy etc). 

     4.1 Palliative Care shall not accept any patient referred through the King Fahad Specialist Hospital referral system.

     4.2 Palliative Care shall not accept patient from outside King Fahad Specialist Hospital unless evaluated by Consultant Oncologist, Haematologist, Radiation Oncologist or Pediatric Haematologist and Oncologist.

     4.3 Palliative Care shall not accept transfer of care for patients who are imminently dying. 

1. Care plan and goals of care are paramount of this standard. A partnership between the PC interdisciplinary team, patient, their family and caregivers is required to enhance:development,adjustment, communication and documentation of plan of care, including setting goals of care and support informed decision making toward the care and advance care planning.
2. The patient involvement in their care is essential while their disease progresses. Their participation in their care and ability to make decisions is required as applicable.
3.  When the patient is incapable to make a decision, a legal guardian should be identified ahead of time to work on the best interest of the patient.
4. Documentation and communication of patient assessment, management, care plans, goals of care, and advance care planning to all healthcare providers involved in the care of the patient is required to ensure best care delivery.